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Sheets of epithelial cells cover the external surface of all metazoans, line internal organs, and divide the animal body into discrete compartments. The epithelium also separates the inner body from the external environment and protects it from damage and infection. Hence, the advent of epithelial layers was an essential part of the evolution of multicellular animals, and epithelial layers are seen in all animals from vertebrates to the most basal metazoans1. The epithelium of some organs is a single monolayer, such as in the lung air sacs, blood vessels, and gut2, as well as in the epidermis of invertebrates such as planaria and cnidarians3. In other tissues, such as the skin4 and cornea5 of vertebrates, the epithelium is stratified, meaning there are multiple epithelial cell layers2. In all cases, the most basal epithelial layer is affixed to the basement membrane, a protein sheet that forms a specialized region of the extracellular matrix (ECM)6,7,8.
Breaches in the epithelium must be rapidly repaired to recreate a continuous epithelial sheet. Damage to the epithelium occurs during natural processes, such as the shedding of epithelial cells in the gut,9,10 and as the result of inflammation or physical trauma. When a single epithelial cell is damaged, it must either repair itself or be eliminated to allow the surrounding cells to attach to each other and close the hole11,12. In wounds larger than the size of a single cell, epithelial cells must move to reach each other and repair the sheet13. This may be achieved by cell spreading if the gaps are small or may require the migration of epithelial cells from the margins of a wound to close the wound gap; this latter process is called re-epithelialization14,15. In embryonic tissues, epithelial cells spread and migrate to close wounds or are pulled across the gap by the contraction of actomyosin cables that form between the cells at the wound margin, in a mechanism resembling a purse string16. In many adult tissues, re-epithelialization involves the migration of coherent cell sheets, where cells maintain their junctions with neighboring cells14,17,18. In other tissues, cell:cell connections are dismantled and epithelial cells behave more like mesenchymal cells, moving in a coordinated but independent manner into the wound region during re-epithelialization14,19,20,21.
Epithelial cell movements are regulated by complex interactions between the migrating cells and between the cells and the ECM. While there is a tremendous amount of experimental literature addressing mechanisms of wound-activation of epithelial cells and subsequent migration, much still remains to be discovered. For example, the initial signal that activates epithelial cells to migrate in response to a wound has not been definitively identified22, nor is it completely understood how actin is redeployed to create lamellipodia on the side of epithelial cells closest to the wound22,23,24,25,26,27. Collective cell migration requires information from cells at the wound to be shared with cells distal to the wound, and the communication pathway is still unclear28. Cell:cell junctions and cell:ECM attachments must be disassembled and reformed as cells in the sheet rearrange themselves, but regulation of this process is poorly understood14,29. Making progress on these and other related questions is not only important as a fundamental biological problem but also because of the clinical significance of correct wound healing. Diseases that compromise the ability of epithelial cells to migrate correctly result in chronic wounds; an example is the genetic disease epidermolysis bullosa, where genes involved in the attachment of the epithelial cells to the ECM are mutated, resulting in fragile skin that peels and blisters. Re-epithelialization is also compromised in naturally aging tissues30,31. A better understanding is therefore essential for developing interventions to improve wound healing outcomes.
Epithelial cell migration in wound healing has been studied using both in vitro approaches and model organisms. The majority of studies of wound healing and mechanisms of cell migration have been carried out in tissue culture, where monolayers of a single epithelial cell type are grown on a substrate that substitutes for the ECM. Cell monolayers are either scratched or grown with stencils to create gaps of specific shapes and sizes and then observed32,33,34. The in vitro model allows an ideal visualization of cell behavior, as well as the opportunity to change qualities of the substrate, to expose cells to drugs and abiotic and biotic factors, and to transfect cells with constructs that express or suppress various genes of interest. However, this reductionist approach may fail to capture some of the important parameters involved in epithelial cell behavior in an in vivo context, including communication between various cell types and signaling events that occur in the ECM11. In vivo models provide the authentic context of a wound, with multiple cell types, overlapping signaling pathways, and a complex ECM35. One such model for wound healing studies is the mouse19, in which recent advances have allowed researchers to observe epidermal cells during healing of full thickness wounds in live animals36. The mouse and other in vivo systems present challenges to study re-epithelialization, however. First, the great advantage of observing cell behavior in a natural context is balanced by the complexity of the temporally overlapping events that occur during vertebrate wound healing, including blood clotting, recruitment of immune cells and inflammation, recruitment of fibroblasts, and cell de-differentiation, re-vascularization, and remodeling of the ECM. Further, opaque tissues make imaging difficult. The Drosophila larva and Zebrafish epidermis systems37,38 have overcome some of these difficulties because of their relative simplicity39.
Our lab recently introduced a new model for studying epithelial wound healing: the medusa (jellyfish) form of the hydrozoan cnidarian Clytia hemisphaerica (Clytia)40. Clytia is an emerging model organism with a fully sequenced and annotated genome41, single cell RNAseq transcriptome42, and protocols in place for genome modification (mutagenesis and transgenesis)43,44,45. Cnidarians are one of the oldest extant lineages to have epithelial layers, so understanding cnidarian wound healing provides insights into the ancestral pathways that ensured epithelial integrity. For those pathways that have been conserved throughout the tree of life, Clytia offers an exciting new system to study epithelial cell dynamics and the functional regulation of wound healing in vivo.
The epithelium covering the upper surface of the Clytia medusa (exumbrella) is a monolayer of transparent, squamous epithelial cells that are approximately 50 µm wide by 1-2 µm thick (Figure 1). They are attached to an ECM called the mesoglea — the "jelly" of the jellyfish. The mesoglea is compositionally similar to the ECM found in other animals46,47,48 including vertebrates, has a basement membrane40, and is completely transparent. The epithelial layer in the Clytia medusa can be easily scratched or wounded (see below). The simplicity and transparency of the epithelium and ECM allows high resolution imaging of the cells and their movements during healing. Recently, Kamran et al. characterized the healing of small wounds in the Clytia epithelium in detail40. It was demonstrated that healing in Clytia occurs through lamellipodia-based cell-crawling, cell spreading, and collective cell migration, as well as purse string closure that is more typical of embryonic systems (although seen previously in adult animal structures such as the cornea49). Clytia wound healing is extremely fast, as has been seen in other systems that lack an inflammatory response40,50. Healing in the Clytia exumbrella is completely dependent on movements of the existing epithelial cells — no cells proliferate or migrate through the ECM to the wound site (Supplemental Movie 1). All of these findings suggest that Clytia is a useful model system to study epithelial wound healing. Indeed, the ease of imaging epithelial cells in Clytia during wound healing led to the discovery that epithelial cell lamellipodia extend and spread over areas of exposed ECM as long as there is an intact basement membrane; if the basement membrane is damaged, epithelial healing switches to a purse string mechanism40. This was the first demonstration of a mechanism underlying the decision to close by lamellipodia-based crawling versus purse string closure, highlighting the importance of specific cell:ECM interactions in healing and of observing cells in their natural context.
Below, protocols are described for creating and imaging single-cell microwounds, small wounds that close primarily by cell spreading, and large wounds that require collective cell migration to close. Furthermore, a protocol is described for the introduction of small molecules into the ECM and epithelial cells, allowing experimental perturbations of putative regulatory pathways of wound healing.